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Chisholm: we're almost there on new contract

GPC chair Dr John Chisholm says negotiators are on course to deliver the new contract

n a few weeks' time, on February 21, we will publish the proposed new GMS contract. It has the potential to transform the working lives of family doctors and reward them for the high-quality service they provide. Understandably, GPs are chafing at the bit to know the detail in order to assess what it means for them and their patients.

I share the anger and disappointment with the six-week delay in announcing the contract. For some GPs it was the last straw and I have no doubt about the impact the delay will have on the GP workforce. But it was felt better to use as much time as possible to get it right rather than deliver an incomplete and flawed contract to a particular timetable.

We are on course to deliver a contract on the new publication date. The GPC negotiators are fully aware of the issues that are crucial. Without satisfactory pricing, fair pensions and a solution to forced allocations, this contract will not solve the problems of general practice.

Assuming a successful outcome to negotiations, the GPC will be submitting joint evidence on the contract to the Review Body, with the Department of Health and the NHS Confederation.

This will be for the Review Body to ratify, not to amend. The evidence will be submitted on the basis that it is subject to a Yes vote from the profession. Should GPs reject the contract, or negotiations not be successful, alternative evidence will be submitted by the GPC after April.

The Review Body recommendations will not be published before April 1 and this means that pay rises for all parts of the profession will need to be backdated to April 1, 2003. Those backdated pay rises must include a significant pay uplift for GPs.

With a radical change to a resourcing system based on a weighted patient basis ­ rather than a system based on the number of doctors in a practice ­ there has to be detailed modelling at practice level to assess the impact on different types of practices. A transitional payment scheme will be introduced to smooth the way from the old contract to the new.

Under the new contract, money will come into the practice from three main strands: the global sum to cover the cost of providing essential and additional services, the quality and outcomes framework, and enhanced services, both local and national.

The needs of your patients will determine how much you receive via the global sum. Practices will decide for themselves how far up the quality ladder they want to progress. Most GPs already do work that will secure them resources from the quality and outcomes framework ­ both advance infrastructure payments and rewards for achievement.

With enhanced services, practices decide where they have a special interest and wish to take on or continue this work and attract the associated payments.

As part of negotiations, we are seeking to ensure GPs are paid for the non-NHS work they do.We are also discussing many other issues such as the possibility of primary care organisations providing an acute in-hours visiting service for patients who are not housebound or terminally ill. All this is still in the melting pot of negotiations. The aim is to deliver a contract that preserves holistic personal care while tackling the fundamental problem of GP workload and recognising the aspirations of the future workforce.

On February 21 we will tell GPs the outcome of the negotiations. During March we will tour the UK explaining the proposals and then we will ballot the profession with a closing date of April 11.

We are almost there, and if successful I believe the new contract will lead to a rejuvenation of general practice as a profession doctors will want to enter and remain in.